Status: Funded - Open
The neuroToxicity of General Anesthesia (TOGA) study
Dawn Gano, M.D., FRCPC
BACKGROUND: An estimated 6 million pediatric patients require general anesthesia for surgery each year in the United States, including 1.5 million infants. A growing body of evidence suggests that general anesthesia has neurotoxic effects on the developing brain in infant animal models, however the risk of abnormal brain development in human infants after exposure to anesthesia is unknown.
GAP: Premature newborns are highly susceptible to alterations in brain development, and frequently require anesthesia for surgery, and, therefore, represent a unique opportunity to evaluate whether general anesthesia is associated with impaired brain development.
HYPOTHESIS: Exposure to general anesthesia among premature newborns is associated with impaired brain growth and microstructural development, and abnormal neurodevelopmental outcome, independent of illness severity.
METHODS: Cohort study of exposure to general anesthesia in premature newborns <33 weeks gestation prospectively evaluated with advanced magnetic resonance imaging (diffusion tensor imaging, magnetic resonance spectroscopic imaging, volumetric morphometric imaging) and standardized neurodevelopmental testing.
IMPACT: Identifying the risk of impaired brain development and adverse neurodevelopmental outcome associated with anesthesia in the neonatal period will enable the development and implementation of strategies to mitigate this risk.
University of California, San Francisco
California, British Columbia